AB0948 SPERM PARAMETERS DIFFER AMONG DIFFERENT SPONDYLOARTHROPATHY CATEGORIES- A PROSPECTIVE CONTROLLED PILOT STUDY
Authors: M. Micu, A. Duțu, S. Surd, M. Mihai, A. Micu
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Fertility impairment may occur in men diagnosed with inflammatory arthritis. High disease activity, sex hormones imbalance and some disease modifying drugs are important factors considered to be involved in this phenomenon [1]. Sperm parameters assessment is of key importance in clinical practice. Studies focusing on fertility assessment in patients diagnosed with spondyloarthritides (SpA) showed discordant results [1]. Indeed, long term treatment with Methotrexate (MTX) raised concerns about its potential negative impact on male fertility although more recent studies do not confirm it [1,2]. <h3>Objectives</h3> To identify potential differences in sperm analysis among patients with ankylosing spondylitis (AS) and psoriatic arthritis (PSA) and to assess the impact of long-term low and intermediate doses of MTX on sperm parameters. <h3>Methods</h3> Consecutive active SpA patients were recruited for sperm parameters assessment. Demographics, type of disease, disease duration, validated activity/skin scores, current therapies and sperm parameters were recorded. Patients in the PSA group underwent sperm parameters assessment at baseline and after chronic MTX treatment. A healthy age matched control group underwent parallel sperm parameters assessment. <h3>Results</h3> Out of 33 SpA patients, 20 patients accepted to undergo sperm parameters evaluation. 15 patients were diagnosed with AS (7 solely with axial involvement) and 5 patients were diagnosed with PSA. Table 1. presents the most important monitored parameters. All patients presented high disease activity measured by ASDAS and DAPSA. All patients had mild Psoriasis Area and Severity Index scores. Both AS patient groups (purely axial, and axial + peripheral) showed comparable sperm parameters to the control group. Chronic MTX therapy was given to 5 AS patients (refractory to Salazopyrin therapy). This subgroup presented normozoospermia. Sperm parameters were profoundly altered in all PSA patients, at baseline and during follow up, when compared to both the AS and control groups. Chronic MTX administration in the PSA group did not supplementarily alter the sperm parameters. On the contrary, in 2 patients a mild sperm concentration and motility increase was detected at follow up. <h3>Conclusion</h3> Our data suggest that PSA patients represent a distinct group inside the SpA disease spectrum and fertility impairment is already a manifestation of early disease. AS patients with early disease onset undergoing treatment (including MTX) have sperm parameters comparable to those of the controls. Chronic MTX therapy in dosages between 15-20 mg/week do not have a negative impact on sperm parameters. <h3>References</h3> [1]Micu MC, Ostensen M, Villiger PM, Micu R, Ionescu R. Paternal exposure to antirheumatic drugs- What physicians should know. Review of the literature. Semin Arthritis Rheum 2018;48 (2):343-355. [2]Grosen A, Bellaguarda E, Nersting J, et al. Low-dose Methotrexate Therapy Does Not Affect Semen Parameters and Sperm DNA. Inflamm Bowel Dis 2022;28(7):1012-1018. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> Mihaela Micu Consultant of: Not linked to this study, Alina Duțu: None declared, Stela Surd: None declared, Minodora Mihai: None declared, Alexandru Micu: None declared.